RICHMOND — Many Virginians are shopping for coverage during the open enrollment period for the 2018 health insurance marketplace under the federal Affordable Care Act (ACA). Whether you are thinking about changing health insurance plans or purchasing new coverage, the State Corporation Commission’s (SCC) Bureau of Insurance encourages Virginians to review their health coverage needs and thoroughly explore all of their options, especially when considering short-term or limited benefit health insurance policies. These types of policies may not comply with ACA essential-benefit requirements and consumers who purchase these policies may be required to pay a fee assessed through their federal income taxes if the only health insurance coverage they have is a short-term or limited benefit policy.
Consumers should keep in mind that short-term and limited benefit health insurance policies may not be subject to ACA rules, such as the requirement that policies provide at least the 10 categories of essential health benefits including hospitalization, ambulatory services, emergency services, maternity and newborn care, mental health and substance use disorder services, prescription drugs, lab tests, preventive care services/chronic disease management, pediatric services and rehabilitative and habilitative services. In addition, these types of policies may deny eligibility for coverage or exclude services because of pre-existing conditions and may apply dollar limits on benefits.
"Knowledge is your best policy when it comes to shopping for insurance," said Virginia Insurance Commissioner Jacqueline K. Cunningham. "Protect yourself physically and financially by understanding enrollment periods, what ACA-compliant plans must cover and where to turn for legitimate information about ACA-compliant coverage. The SCC’s Bureau of Insurance can help Virginians determine if a plan meets ACA requirements," she said.
The Bureau offers Virginians the following tips in the event they see advertisements or are solicited by someone trying to sell them health insurance
- Check the Bureau of Insurance website at http://www.scc.virginia.gov/boi/pubs/hbp_indv18.pdf for a list of carriers that have received approval to offer ACA-compliant health benefit plans to individuals on and off the federal Marketplace in Virginia for 2018.
- The official website for the federal Marketplace is www.healthcare.gov . Here you can find information regarding the Affordable Care Act, qualified health plans and comparisons of Marketplace plans. Be wary of other similar sounding names or websites.
- The open enrollment period for the 2018 health insurance marketplace under the ACA ends December 15, 2017. Anyone contacting you to sell individual health insurance plans through an "enrollment period" outside of the open enrollment period is not selling an ACA-compliant policy.
- No one offering ACA-compliant health care coverage will ask you if you have a pre-existing condition.
- Be wary of telemarketers from the "national enrollment center," "national healthcare center," or other official-sounding name. The federal government will not call to sell you health insurance.
- Do not provide your Social Security number, bank account details or health information to a cold caller and never agree to any request to send money over the phone.
- When purchasing insurance through an agent, make sure that person is a licensed agent and ask for the individual’s license number. If they refuse, do not do business with them. To check if a person is licensed in Virginia, visit https://www.scc.virginia.gov/boi/ConsumerInquiry/.
- Ask for details of any health insurance policy, including premiums, in writing.
For additional information, contact the Consumer Services Section of the Virginia Bureau of Insurance’s Life and Health Division at 1-877-310-6560 or visit www.scc.virginia.gov/boi.